RELIGIOUS ORGANIZATIONS AND HIV
RELEASE DATE: June 22, 2004
PA NUMBER: PA-04-115
(August 17, 2006 - This PA has been Amended, see NOT-HD-06-008 - R21s no longer accepted relating to this announcement)
EXPIRATION DATE: September 02, 2006, unless reissued
Department of Health and Human Services (DHHS)
PARTICIPATING ORGANIZATION:
National Institutes of Health (NIH)
(http://www.nih.gov)
COMPONENT OF PARTICIPATING ORGANIZATION:
National Institute of Child Health and Human Development (NICHD)
(http://www.nichd.nih.gov/)
APPLICATION RECEIPT DATES: September 01, 2004, September 01, 2005,
September 01, 2006
CATALOG OF FEDERAL DOMESTIC ASSISTANCE NUMBER(S): 93.865
THIS PA CONTAINS THE FOLLOWING INFORMATION
o Purpose of this PA
o Research Objectives
o Mechanisms of Support
o Eligible Institutions
o Individuals Eligible to Become Principal Investigators
o Special Requirements
o Where to Send Inquiries
o Submitting an Application
o Peer Review Process
o Review Criteria
o Award Criteria
o Required Federal Citations
PURPOSE OF THIS PA
Religion is a powerful force worldwide. Estimates suggest that over 80 percent
of the world's population identifies with some established religion. Religious
organizations exist in virtually all societies and play varying roles in
setting moral and behavioral standards. Religious beliefs, religious
practices, and religious organizations have clear relevance to sexual
behaviors related to HIV risk as well as to the ways in which HIV-positive
individuals are viewed and cared for. This PA calls for studies to examine the
extent and nature of religious organizations' involvement in HIV-related
activities, the factors that influence such involvement and its effectiveness.
The focus is on religious organizations or congregations such as churches,
synagogues or mosques. Faith-based organizations -- i.e., those supported by
or tied to religious organizations, but not directly providing religious
services -- may be involved in the research, but are not the focus of the
research.
RESEARCH OBJECTIVES
Background
Religious organizations have long engaged in HIV-related activities such as
providing educational interventions and caring for the affected and infected.
In many locations around the world, such organizations have been in the
forefront or alone in the struggles to ameliorate the suffering of HIV-
infected people and their families. However, little systematic knowledge
exists concerning how religious organizations, in themselves, influence risk
and prevention strategies and responses to HIV at the individual, community,
and societal levels. Furthermore, little is known about what aspects of this
influence may be unique to the "faith" dimension of such organizations. A
scientifically-focused knowledge base will contribute not only to an improved
understanding of the factors driving HIV risk, prevention, and care world-
wide, but also to the development of innovative prevention and care strategies
that build on the strengths and unique features of religious organizations.
There are many ways in which religious organizations may contribute to HIV
prevention and care. These include shaping family and community values around
sexual behavior and other behaviors associated with HIV risk; supporting
families and communities in the enforcement of norms and values; providing
direct guidance or information to congregants regarding HIV risk behaviors;
providing care to HIV-infected individuals and their families; connecting
congregants to HIV-related services; creating networks and cooperating with
other organizations involved in HIV-related services and/or conducting
outreach to individuals and groups at high risk of HIV. Many factors may
influence the extent and nature of a religious organization's involvement in
HIV-related activities. Members' and leaders' views of the organization's
mission are one potential factor. Doctrines that prescribe specific norms of
sexual behavior may strongly affect the type of messages and activities
promoted. The norms and characteristics of the local populations -- both those
proximate to the organization and those served by it -- may have an effect, as
may the scope of the organization's connections to community members and
groups at risk of HIV. The size, structure, and function (e.g., priority-
setting, selection of leaders) of the organization and its linkages to other
community organizations may also be influential. Impact of HIV-related
activities may be influenced by such factors as the strength of members' ties
to the organization, the ability of the organization to retain its youth
members, the influence of the organization in the community and culture,
cultural consonance between the organization and the local population,
networks with other organizations, and the personal strengths of
organizational leaders.
To have an impact, HIV prevention efforts must reach people at high risk for
infection and those who are already infected to encourage them to avoid
spreading infection. Successful efforts may work indirectly as well as
directly. To the extent that at-risk individuals are disconnected from
religious organizations yet connected to less formal social structures such as
local bars or social clubs, there may be alternative routes to reaching high-
risk populations. Alternatively, religious organizations can alter the
conditions and norms of the community in ways that indirectly aid in the
prevention of HIV, through altered norms regarding sex or drug use, safer
streets, stronger families, or stronger neighborhood ties.
Research Scope
This announcement focuses specifically on the activities and impact of
religious organizations. The term "religious organization" here refers to a
body or organization the primary purpose of which is religious worship. Types
of religious organizations include churches, mosques, or synagogues; some
researchers use the term "congregation" to refer to such entities. Faith-based
organizations include religious organizations, but may also include
organizations that are supported by or tied to religious organizations, may
include worship in their activities, but do not exist primarily for the
purpose of religious worship. Examples include groups and organizations,
affiliated with a particular denomination or set of denominations that provide
social or educational services (e.g., Catholic Charities) or promote social
change (e.g., Promise-Keepers). These types of faith-based organizations are
not the central focus of the research. However, religious organizations'
relationships with faith-based organizations may be appropriately studied in
research responsive to this announcement.
This initiative invites social science research directed toward building a
knowledge base concerning the extent and nature of religious organizations'
involvement in HIV-related activities, and the factors that influence such
involvement and its effectiveness. Activities related to reducing HIV risk and
prevalence, ameliorating the lives and care of HIV-infected individuals, and
reducing the costs of HIV infection to communities are all considered relevant
under this announcement.
The research proposed must be informed by clearly articulated theory
addressing HIV risk and prevention, religion and/or religious organizations,
and organizations and their functions. Applicants are encouraged to think
creatively and broadly in developing a theoretical framework. It is hoped that
research carried out under this initiative will contribute to the further
development of theory regarding the role of community institutions in HIV
prevention. Researchers are encouraged to consider a full range of appropriate
qualitative and quantitative methods in designing their research.
Multidisciplinary approaches are encouraged, but not required. Applicants may
consider the involvement of a wide range of scientists, in addition to those
with expertise in the HIV/AIDS arena. Others may include, but are not limited
to, those who study religion, institutional organization, service delivery,
behavior change, persuasive communication, and community organization and
dynamics. Anthropologists, demographers, geographers, economists, political
scientists, psychologists, theologians, and sociologists all might have skills
of use in developing these studies. We strongly encourage research teams to
include significant, substantive involvement of individuals from the
institution or institutions to be the focus of the study.
Relevant research questions include, but are not limited to:
Involvement
o To what extent are religious organizations involved in activities related to
HIV prevention and care?
o How do the structures and function of individual religious organizations
influence whether they become involved in HIV-related activities and the
specific roles they play?
o To what extent is a religious organization's involvement in HIV-related
activities related to the personal experience, vision, or ability of specific
leaders and to what extent does it result from organizational characteristics?
o How is a religious organization's involvement in HIV-related activities
influenced by specific elements in organizational missions and doctrines, and
the flexibility with which these elements can be interpreted?
o How do the characteristics of local communities and populations served by
the religious organization influence involvement in HIV-related activities?
o To what extent do religious organizations develop active networks with other
organizations involved with HIV prevention and care? How are these networks
used and sustained?
Impact
o To what extent are individuals who are HIV-positive or at high risk for HIV
exposure connected to religious organizations? Do these connections help to
strengthen people's abilities to avoid risk?
o How can religious organizations effectively reach individuals who are HIV-
positive or at high risk of HIV infection? Do efforts to reach out to such
individuals have adverse effects on the participation or retention of not-at-
risk populations in the organization? Conversely, what deters at-risk
populations from participation in religious organizations?
o What are the mechanisms through which religious organizations influence HIV
risk and protective behaviors?
o How do religious organizations shape and enforce community norms relevant to
HIV risk, specifically sexual risk and injection drug use? How does this
differ by type, structure of the organization, or community context?
o How does a religious organization's ability to retain the involvement of
youth and geographically mobile members affect its ability to influence HIV-
related outcomes in the community?
o How effective are "commuter" churches -- religious organizations located in
poor inner-city neighborhoods, but attended by non-community residents -- in
influencing HIV-related outcomes in the local community?
o In what ways do local religious organizations impede effective HIV
prevention or encourage risky behaviors? What factors are responsible and how
can they be addressed? Does stigma play a role?
o Do the teachings, norms, structure, and operation of religious organizations
in particular communities influence community rates of HIV-related behavior?
o Does the influence or dominance of a religious organization in a local
community, or the cultural consonance between the organization and the local
population, influence the impact of the organization's HIV-related activities
on HIV-related outcomes in the community?
o Does cooperation or conflict (e.g., over appropriate prevention messages)
among religious organizations and between religious and other organizations in
communities influence these outcomes?
o How is a religious organization's capacity or ability to enforce norms,
affect behavior or reduce stigma affected by its location within its broader
local community? Are certain characteristics -- for instance, its membership
composition, its theology, its resources -- more useful in some communities
than in others?
o How does the larger economic, political, and cultural context in which
specific religious organizations are embedded relate to their effect on HIV-
related outcomes in their communities?
o What is the role of religious leaders and gatekeepers in creating and
sustaining or deterring and avoiding prevention efforts? How does
institutional involvement in HIV prevention that is initiated by an individual
leader at one organization become "institutionalized?”
MECHANISM OF SUPPORT
This PA will use the NIH Research Project Grant (R01) and
Exploratory/Developmental Grant (R21) award mechanisms. As an applicant you
will be solely responsible for planning, directing, and executing the proposed
project.
The R21 mechanism is intended to encourage new exploratory and developmental
research projects and/or exploration of novel hypotheses and strategies. For
example, such projects could assess the feasibility of a novel area of
investigation or a new experimental system. These projects should be
exploratory and novel, and distinct from the type of project supported through
the traditional R01. Specific instructions for the use of the R21 mechanism
may be found at: http://grants.nih.gov/grants/guide/pa-files/PA-03-107.html.
This PA uses just-in-time concepts. It also uses the modular as well as the
non-modular budgeting formats (see
http://grants.nih.gov/grants/funding/modular/modular.htm). Specifically, if
you are submitting an application with direct costs in each year of $250,000
or less, use the modular format. Otherwise follow the instructions for non-
modular research grant applications. This program does not require cost
sharing as defined in the current NIH Grants Policy Statement at
http://grants.nih.gov/archive/grants/policy/nihgps_2001/part_i_1.htm.
ELIGIBLE INSTITUTIONS
You may submit an application if your institution has any of the following
characteristics:
o For-profit or non-profit organizations
o Public or private institutions, such as universities, colleges, hospitals,
and laboratories
o Units of State and local governments
o Eligible agencies of the Federal government
o Domestic or foreign institutions/organizations
o Faith-based or community-based organizations
INDIVIDUALS ELIGIBLE TO BECOME PRINCIPAL INVESTIGATORS
Any individual with the skills, knowledge, and resources necessary to carry
out the proposed research is invited to work with his/her institution to
develop an application for support. Individuals from underrepresented racial
and ethnic groups as well as individuals with disabilities are always
encouraged to apply for NIH programs.
SPECIAL REQUIREMENTS
Budget requests should include funding for one trip per year by the Principal
Investigator to an annual meeting of grantees supported through this
initiative.
This PA has one receipt date per year: September 1. See the "Submitting an
Application" section of this announcement for details.
WHERE TO SEND INQUIRIES
We encourage your inquiries concerning this PA and welcome the opportunity
answer questions from potential applicants. Inquiries may fall into two
areas: scientific/research and financial or grants management issues:
o Direct your questions about scientific/research issues to:
Susan Newcomer, Ph.D.
Demographic and Behavioral Sciences Branch
National Institute of Child Health and Human Development
6100 Executive Boulevard, 8B07, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 435-6981
FAX: (301) 496-0962
Email: Snewcomer@nih.gov
o Direct your questions about financial or grants management matters to:
Annette Hanopole
Grants Management Branch
National Institute of Child Health and Human Development
6100 Executive Boulevard, 8A17, MSC 7510
Bethesda, MD 20892-7510
Telephone: (301) 435-6975
FAX: (301) 402-0915
Email: hanopola@mail.nih.gov
SUBMITTING AN APPLICATION
Applications must be prepared using the PHS 398 research grant application
instructions and forms (rev. 5/2001). Applications must have a Dun and
Bradstreet (D&B) Data Universal Numbering System (DUNS) number as the
Universal Identifier when applying for Federal grants or cooperative
agreements. The DUNS number can be obtained by calling (866) 705-5711 or
through the web site at http://www.dunandbradstreet.com/. The DUNS number
should be entered on line 11 of the face page of the PHS 398 form. The PHS 398
is available at http://grants.nih.gov/grants/funding/phs398/phs398.html in an
interactive format. For further assistance contact GrantsInfo, Telephone
(301) 435-0714, Email: GrantsInfo@nih.gov.
The title and number of this program announcement must be typed on line 2 of
the application form and the YES box must be checked.
SUPPLEMENTARY INSTRUCTIONS: Applicants submitting R21 applications must
follow the guidelines for the Exploratory/Developmental grant mechanism,
available at: http://grants.nih.gov/grants/guide/pa-files/PA-03-107.html
SPECIFIC INSTRUCTIONS FOR MODULAR GRANT APPLICATIONS: Applications requesting
up to $250,000 per year in direct costs must be submitted in a modular grant
format. The modular grant format simplifies the preparation of the budget in
these applications by limiting the level of budgetary detail. Applicants
request direct costs in $25,000 modules. Section C of the research grant
application instructions for the PHS 398 (rev. 5/2001) at
http://grants.nih.gov/grants/funding/phs398/phs398.html includes step-by-step
guidance for preparing modular grants. Additional information on modular
grants is available at
http://grants.nih.gov/grants/funding/modular/modular.htm.
SPECIFIC INSTRUCTIONS FOR APPLICATIONS REQUESTING $500,000 OR MORE PER YEAR:
Applications requesting $500,000 or more in direct costs for any year must
include a cover letter identifying the NIH staff member within one of NIH
institutes or centers who has agreed to accept assignment of the application.
Applicants requesting more than $500,000 must carry out the following steps:
1) Contact the IC program staff at least six weeks before submitting the
application, i.e., as you are developing plans for the study;
2) Obtain agreement from the IC staff that the IC will accept your application
for consideration for award; and,
3) Identify, in a cover letter sent with the application, the staff member and
IC who agreed to accept assignment of the application.
This policy applies to all investigator-initiated new (type 1), competing
continuation (type 2), competing supplement, or any amended or revised version
of these grant application types. Additional information on this policy is
available in the NIH Guide for Grants and Contracts, October 19, 2001 at
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-004.html.
SENDING AN APPLICATION TO THE NIH: Submit a signed, typewritten original of
the application, including the checklist, and five signed photocopies in one
package to:
Center for Scientific Review
National Institutes of Health
6701 Rockledge Drive, Room 1040, MSC 7710
Bethesda, MD 20892-7710
Bethesda, MD 20817 (for express/courier service)
APPLICATION PROCESSING: Applications submitted in response to this program
announcement (PA) will be accepted ONLY on September 1, 2004, September 1,
2005, and September 1, 2006. If sufficient responsive applications are
received at that time, a Special Emphasis Panel (SEP) will be organized to
review them. If not, the applications will be reviewed in the regular AIDS
expedited review panels.
The CSR will not accept any application in response to this PA that is
essentially the same as one currently pending initial review unless the
applicant withdraws the pending application. The CSR will not accept any
application that is essentially the same as one already reviewed. This does
not preclude the submission of a substantial revision of an unfunded version
of an application already reviewed, but such application must include an
Introduction addressing the previous critique.
Although there is no immediate acknowledgement of the receipt of an
application, applicants are generally notified of the review and funding
assignment within eight weeks.
PEER REVIEW PROCESS
Applications submitted for this PA will be assigned on the basis of
established PHS referral guidelines. An appropriate scientific review group
convened in accordance with the standard NIH peer review procedures
(http://www.csr.nih.gov/refrev.htm) will evaluate applications for scientific
and technical merit.
As part of the initial merit review, all applications will:
o Undergo a selection process in which only those applications deemed to have
the highest scientific merit, generally the top half of applications under
review, will be discussed and assigned a priority score
o Receive a written critique
o Receive a second level review by the appropriate national advisory council
or board.
REVIEW CRITERIA
The goals of NIH-supported research are to advance our understanding of
biological systems, improve the control of disease, and enhance health. In
the written comments, reviewers will be asked to discuss the following aspects
of the application in order to judge the likelihood that the proposed research
will have a substantial impact on the pursuit of these goals:
o Significance
o Approach
o Innovation
o Investigator
o Environment
The scientific review group will address and consider each of these criteria
in assigning the application's overall score, weighting them as appropriate
for each application. The application does not need to be strong in all
categories to be judged likely to have major scientific impact and thus
deserve a high priority score. For example, an investigator may propose to
carry out important work that by its nature is not innovative but is essential
to move a field forward.
SIGNIFICANCE: Does this study address an important problem? If the aims of
the application are achieved, how will scientific knowledge be advanced? What
will be the effect of these studies on the concepts or methods that drive this
field?
APPROACH: Are the conceptual framework, design, methods, and analyses
adequately developed, well-integrated, and appropriate to the aims of the
project? Does the applicant acknowledge potential problem areas and consider
alternative tactics?
INNOVATION: Does the project employ novel concepts, approaches or methods?
Are the aims original and innovative? Does the project challenge existing
paradigms or develop new methodologies or technologies?
INVESTIGATOR: Is the investigator appropriately trained and well suited to
carry out this work? Is the work proposed appropriate to the experience level
of the Principal Investigator and other researchers (if any)?
ENVIRONMENT: Does the scientific environment in which the work will be done
contribute to the probability of success? Do the proposed experiments take
advantage of unique features of the scientific environment or employ useful
collaborative arrangements? Is there evidence of institutional support?
ADDITIONAL REVIEW CRITERIA: In addition to the above criteria, the following
items will be considered in the determination of scientific merit and the
priority score:
PROTECTION OF HUMAN SUBJECTS FROM RESEARCH RISK: The involvement of human
subjects and protections from research risk relating to their participation in
the proposed research will be assessed
(http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm). (See
criteria included in the section on Federal Citations, below.)
INCLUSION OF WOMEN, MINORITIES AND CHILDREN IN RESEARCH: The adequacy of plans
to include subjects from both genders, all racial and ethnic groups (and
subgroups), and children as appropriate for the scientific goals of the
research will be assessed. Plans for the recruitment and retention of
subjects will also be evaluated. (See Inclusion Criteria in the sections on
Federal Citations, below.)
ADDITIONAL REVIEW CONSIDERATIONS
Sharing Research Data: Applicants requesting more than $500,000 in direct
costs in any year of the proposed research are expected to include a data
sharing plan in their application. The reasonableness of the data sharing plan
or the rationale for not sharing research data will be assessed by the
reviewers. However, reviewers will not factor the proposed data sharing plan
into the determination of scientific merit or priority score.
BUDGET: The reasonableness of the proposed budget and the requested period of
support in relation to the proposed research.
AWARD CRITERIA
Applications submitted in response to a PA will compete for available funds
with all other recommended applications. The following will be considered in
making funding decisions:
o Scientific merit of the proposed project as determined by peer review
o Availability of funds
o Relevance to program priorities
REQUIRED FEDERAL CITATIONS
HUMAN SUBJECTS PROTECTION: Federal regulations (45CFR46) require that
applications and proposals involving human subjects must be evaluated with
reference to the risks to the subjects, the adequacy of protection against
these risks, the potential benefits of the research to the subjects and
others, and the importance of the knowledge gained or to be gained
(http://www.hhs.gov/ohrp/humansubjects/guidance/45cfr46.htm).
INCLUSION OF WOMEN AND MINORITIES IN CLINICAL RESEARCH: It is the policy of
the NIH that women and members of minority groups and their sub-populations
must be included in all NIH-supported clinical research projects unless a
clear and compelling justification is provided indicating that inclusion is
inappropriate with respect to the health of the subjects or the purpose of the
research. This policy results from the NIH Revitalization Act of 1993
(Section 492B of Public Law 103-43).
All investigators proposing clinical research should read the "NIH Guidelines
for Inclusion of Women and Minorities as Subjects in Clinical Research -
Amended, October, 2001," published in the NIH Guide for Grants and Contracts
on October 9, 2001
(http://grants.nih.gov/grants/guide/notice-files/NOT-OD-02-001.html);
a complete copy of the updated Guidelines is available at
http://grants.nih.gov/grants/funding/women_min/guidelines_amended_10_2001.htm.
The amended policy incorporates: the use of an NIH definition of clinical
research; updated racial and ethnic categories in compliance with the new OMB
standards; clarification of language governing NIH-defined Phase III clinical
trials consistent with the new PHS Form 398; and updated roles and
responsibilities of NIH staff and the extramural community. The policy
continues to require for all NIH-defined Phase III clinical trials that: a)
all applications or proposals and/or protocols must provide a description of
plans to conduct analyses, as appropriate, to address differences by
sex/gender and/or racial/ethnic groups, including subgroups if applicable; and
b) investigators must report annual accrual and progress in conducting
analyses, as appropriate, by sex/gender and/or racial/ethnic group
differences.
INCLUSION OF CHILDREN AS PARTICIPANTS IN RESEARCH INVOLVING HUMAN SUBJECTS:
The NIH maintains a policy that children (i.e., individuals under the age of
21) must be included in all human subjects research, conducted or supported by
the NIH, unless there are scientific and ethical reasons not to include them.
All investigators proposing research involving human subjects should read the
"NIH Policy and Guidelines" on the inclusion of children as participants in
research involving human subjects that is available at
http://grants.nih.gov/grants/funding/children/children.htm.
REQUIRED EDUCATION ON THE PROTECTION OF HUMAN SUBJECT PARTICIPANTS: NIH
policy requires education on the protection of human subject participants for
all investigators submitting NIH proposals for research involving human
subjects. You will find this policy announcement in the NIH Guide for Grants
and Contracts Announcement, dated June 5, 2000, at
http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html.
PUBLIC ACCESS TO RESEARCH DATA THROUGH THE FREEDOM OF INFORMATION ACT: The
Office of Management and Budget (OMB) Circular A-110 has been revised to
provide public access to research data through the Freedom of Information Act
(FOIA) under some circumstances. Data that are (1) first produced in a
project that is supported in whole or in part with Federal funds and (2) cited
publicly and officially by a Federal agency in support of an action that has
the force and effect of law (i.e., a regulation) may be accessed through FOIA.
It is important for applicants to understand the basic scope of this
amendment. NIH has provided guidance at
http://grants.nih.gov/grants/policy/a110/a110_guidance_dec1999.htm.
Applicants may wish to place data collected under this PA in a public archive,
which can provide protections for the data and manage the distribution for an
indefinite period of time. If so, the application should include a
description of the archiving plan in the study design and include information
about this in the budget justification section of the application. In
addition, applicants should think about how to structure informed consent
statements and other human subjects procedures given the potential for wider
use of data collected under this award.
URLs IN NIH GRANT APPLICATIONS OR APPENDICES: All applications and proposals
for NIH funding must be self-contained within specified page limitations.
Unless otherwise specified in an NIH solicitation, Internet addresses (URLs)
should not be used to provide information necessary to the review because
reviewers are under no obligation to view the Internet sites. Furthermore, we
caution reviewers that their anonymity may be compromised when they directly
access an Internet site.
HEALTHY PEOPLE 2010: The Public Health Service (PHS) is committed to
achieving the health promotion and disease prevention objectives of "Healthy
People 2010," a PHS-led national activity for setting priority areas. This PA
is related to one or more of the priority areas. Potential applicants may
obtain a copy of "Healthy People 2010" at http://www.health.gov/healthypeople.
AUTHORITY AND REGULATIONS: This program is described in the Catalog of
Federal Domestic Assistance at http://www.cfda.gov/ and is not subject to the
intergovernmental review requirements of Executive Order 12372 or Health
Systems Agency review. Awards are made under the authorization of Sections
301 and 405 of the Public Health Service Act as amended (42 USC 241 and 284)
and under Federal Regulations 42 CFR 52 and 45 CFR Parts 74 and 92. All
awards are subject to the terms and conditions, cost principles, and other
considerations described in the NIH Grants Policy Statement. The NIH Grants
Policy Statement can be found at
http://grants.nih.gov/grants/policy/policy.htm.
The PHS strongly encourages all grant recipients to provide a smoke-free
workplace and discourage the use of all tobacco products. In addition, Public
Law 103-227, the Pro-Children Act of 1994, prohibits smoking in certain
facilities (or in some cases, any portion of a facility) in which regular or
routine education, library, day care, health care, or early childhood
development services are provided to children. This is consistent with the
PHS mission to protect and advance the physical and mental health of the
American people.